scholarly journals The effect of excisional arthroplasty with palmaris longus tendon on carpal height ratio in Stage 3 Kienböck’s disease

2011 ◽  
Vol 45 (6) ◽  
pp. 393-398 ◽  
Author(s):  
Levent Kucuk
Keyword(s):  
Height Ratio ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Palmaris Longus Tendon ◽  
Carpal Height ◽  
Kienbock’S Disease

KIENBÖCK DISEASE TREATED BY EXCISIONAL ARTHROPLASTY WITH A PALMARIS LONGUS TENDON BALL: A COMPARATIVE STUDY OF CASES WITH OR WITHOUT BONE CORE

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 145-149 ◽  
Author(s):  
A. Sakai ◽  
N. Toba ◽  
T. Oshige ◽  
K. Menuki ◽  
H. Hirasawa ◽  
...  
Keyword(s):  
Comparative Study ◽  
Stage Iiia ◽  
Height Ratio ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Kienböck Disease ◽  
Palmaris Longus Tendon ◽  
One Year ◽  
Carpal Height

We hypothesised that using a palmaris longus tendon ball (PLTB) with bone core (w bc) after excisional arthroplasty for Kienböck disease would maintain post-operative carpal height compared to a PLTB without bone core (w/o bc). Seventeen hands of 16 consecutive patients with Kienböck disease at Lichtman stage IIIA or IIIB were treated by replacement of the lunate with a PLTB w bc or w/o bc. We evaluated the clinical and radiological outcomes at one, three and 12 months after surgery. According to Dornan and Lichtman criteria respectively, there were no significant differences between the two groups. In the w bc group, the post-operative values of the carpal height ratio (CHR) were maintained at the same level as pre-operative values for one year, while the post-operative CHR values in the w/o bc group were significantly lower than those in the w bc group. Our results indicate that in Kienböck disease, arthroplasty using a PLTB w bc can maintain CHR at one year after surgery compared to arthroplasty using a PLTB w/o bc.

Changes in Carpal Alignment Following Radial Osteotomy for Kienböck’s Disease

1993 ◽  
Vol 18 (3) ◽  
pp. 289-293 ◽  
Author(s):  
K. TSUNODA ◽  
R. NAKAMURA ◽  
K. WATANABE ◽  
E. HORII ◽  
T. MIURA
Keyword(s):  
Clinical Outcome ◽  
Contact Area ◽  
Axial Load ◽  
Height Ratio ◽  
Distance Ratio ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Carpal Height ◽  
Kienbock’S Disease

Changes in carpal alignment following radial osteotomy were studied in 30 patients with Kienböck’s disease. The carpal height ratio and carpal-ulnar distance ratio were significantly less in wrists with Kienböck’s disease than unaffected wrists. This observation implies proximal-ulnar translation of the capitate. In addition, the lunate-covering ratio increased significantly, reflecting radial translation of the lunate. Radial osteotomy corrected ulnar translation of the capitate and increased the radial translation of the lunate, thus increasing the lunate-covering ratio. The increased lunate-covering ratio is believed to increase the area of distribution of the axial load through the lunate by increasing the contact area with the radius. The satisfactory clinical outcome of radial osteotomy is believed to be due to this effect on carpal alignment.

scholarly journals Radiographic and Computed Tomography Correlation of Kienböck's Disease: Is There a Need to Revisit Staging with Improved Imaging?

2019 ◽  
Vol 09 (01) ◽  
pp. 039-043
Author(s):  
Arvind Mohan ◽  
Richard Knight ◽  
Hiba Ismail ◽  
Ian A. Trail
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Ulnar Variance ◽  
Height Ratio ◽  
Carpal Collapse ◽  
Kienböck’S Disease ◽  
X Ray ◽  
Kienböck's Disease ◽  
Carpal Height ◽  
Kienbock’S Disease

AbstractCarpal height ratio and ulnar variance on plain X-ray were measured and compared to the width/height ratio of the lunate as measured on a computed tomography (CT) scan in 50 patients with Kienböck's disease. Width/height ratio of the lunate was also measured in a series of 50 controls. No correlation between ulnar variance and fractures was found. Conversely, the correlation between carpal height ratio on X-ray and width/height ratio on a CT scan was statistically significant. Similarly, the correlation between ulnar variance and width/height ratio was statistically significant. We have concluded that width/height ratio while correlating with carpal height is a better measure of lunate collapse. It also appeared that lunate collapse precedes carpal collapse, specifically most if not all lunates have collapsed prior to reduction in carpal height ratio. Finally, while we are unable to conclude the level at which the width/height ratio of lunate becomes unreconstructable, it does appear that in all Litchman stage 3b and most if not all of 3a the shape of the lunate has altered significantly.

scholarly journals Extensor carpi radialis longus tendon ball interposition arthroplasty for treatment of late-stage Kienböck’s disease: Short-term results of a novel technique

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880251
Author(s):  
Okan Aslantürk ◽  
Kadir Ertem ◽  
Emre Ergen ◽  
Muhammed Köroğlu
Keyword(s):  
Late Stage ◽  
Visual Analog Scale Score ◽  
Height Ratio ◽  
Short Term ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Extensor Carpi Radialis ◽  
Carpal Height ◽  
Kienbock’S Disease

Purpose: The aim of this study was to evaluate short-term clinical and radiological results of extensor carpi radialis longus (ECRL) tendon ball arthroplasty for treatment of late-stage Kienböck’s disease. Methods: We retrospectively reviewed data of 19 patients suffering from Kienböck’s treated with ECRL tendon ball arthroplasty between December 2014 and December 2016. Patients’ clinical functions were assessed using grip strength, range of motion (ROM) of the wrist, QuickDASH, Mayo wrist score, and visual analog scale score. Radiological examination was performed to assess carpal height ratio and progression of arthritis. Results: The median follow-up was 30 months (range, 12–36 months). At final follow-up, ROM of operated wrist was 71% of the nonoperated side. Thirteen (86.6%) patients were pain free. Carpal height ratio was statistically significantly reduced compared with preoperative values. All patients declared their satisfaction with the results due to their preoperative status. Conclusions: ECRL tendon ball arthroplasty is a new and good option for treatment of late-stage Kienböck’s disease with low complication rate.

scholarly journals The outcome of treatment of Kienbock's disease stage III by excisional arthroplasty and palmaris longus spacer

2021 ◽  
Vol 2 (2) ◽  
pp. 158-166
Author(s):  
Al Bayati MA ◽  
Muttar AY ◽  
Al-Khishali TJ ◽  
Al Bayati MM ◽  
Hameed BM
Keyword(s):  
Case Series ◽  
Hospital Environment ◽  
Stage Iii ◽  
Disease Stage ◽  
Dash Score ◽  
Level Of Evidence ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Palmaris Longus ◽  
Kienbock’S Disease

Purpose: To present the outcomes of treatment of Kienbock's Disease (KD) stage III, by excisional arthroplasty of lunate with Palmaris Longus (PL) tendon as a spacer. Methods: Twenty-one patients were diagnosed with KD stage III, 14 females, and 7 males. They were treated by excision of the lunate plus PL tendon ball as a spacer. Mean follow up period was 38 months (24-60). Pre- and post-operative treatment assessment were by recording the clinical examination data, the investigation by radiological imaging (plain and CT scan), MRI, and scoring of Disabilities of Arm, Shoulder and Hand (DASH) system. Results: Nineteen patients improved clinically to a great extent, by relieving symptoms, a better range of movement, functional satisfaction and no conspicuous Carpal Height Ratio (CHR) change. Mean DASH score improved from 38.5 to 6.8. Two patients had less favorable clinical outcome, yet, they were not interested to have further operations. Conclusions: Treatment of KD stage III by excisional arthroplasty plus palmaris longus tendon spacer is a low demand operation, which can be performed in a moderate hospital environment, and can accomplish good satisfactory results comparable to other more sophisticated, costly procedures. Type of study/Level of evidence: Prospective case series, level IV.

Kienböck’s Disease, Early Stage 3––Height Reconstruction and Core Revascularization of the Lunate

1994 ◽  
Vol 19 (4) ◽  
pp. 466-478 ◽  
Author(s):  
R. C. BOCHUD ◽  
U. BÜCHLER
Keyword(s):  
Bone Grafting ◽  
Early Stage ◽  
Disease Process ◽  
Wrist Motion ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Shortening Osteotomy ◽  
Final Score ◽  
Carpal Height ◽  
Kienbock’S Disease

Early stage 3 Kienböck’s disease has been treated by inner débridement, recontouring, height reconstruction, bone grafting and core revascularization of the lunate; additional procedures included temporary external fixation of the wrist and/or shortening osteotomy of the radius in selected cases. 26 patients, representing an uninterrupted series of 28 procedures, were followed-up for an average of 6.7 years (range 2.5–9.3 years) with periodic clinical and radiographic evaluations until they reached the final comprehensive assessment that included trispiral tomography and MRI. Every patient was subjectively improved, pleased with the result and able to resume his previous job. Pain intensity, rated on a zero to five scale, improved from 2.5 points pre-operatively to a final score of 0.8 points. Wrist motion gained slightly. Grip strength improved significantly. Lunate reconstruction proved successful in 37% of the cases; in an additional 23%, the disease process was stabilized. Carpal height decreased 4.7%; ulnar translation was not substantially altered. Arthrosis increased postoperatively in 55%, remained unchanged in 36% and progressed in 9%. Overall, 43% good and excellent, 43% fair and 14% poor results were observed.

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